Individual
DR. DIANE JANE AXELROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
5225 NESCONSET HWY STE 40, PORT JEFFERSON STATION, NY 11776-2060
(631) 928-2830
(631) 928-2915
Mailing address
5225 NESCONSET HWY STE 40, PORT JEFFERSON STATION, NY 11776-2060
(631) 928-2830
(631) 928-2915
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
042137-1
NY
Other
Enumeration date
04/05/2013
Last updated
04/05/2013
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